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Aug 24, 2008

Treatment of peripapillary CNV with AvastinIn age-related macular degeneration, choroidal neovascularization (CNV) usually arises in the macula, presumably triggered by the presence of drusen. However, CNV may also arise at the margin of the optic disc, either spontaneously (idiopathic CNV) or in response to disc drusen, ocular histoplasmosis, or other defects at the optic disc margin. Investigators studied the effect of intravitreal injections of Avastin in the treatment of peripapillary CNV.

Six eyes of five patients with peripapillary choroidal membranes were included in the study with a mean follow-up of 13 months (range 6 to 16). Avastin was used as the initial treatment in four eyes and to manage recurrences after surgery in the other two. Examination included best-corrected visual acuity, fundus biomicroscopy, fluorescein angiography and optical coherence tomography (OCT). Avastin injections were repeated monthly for the first 3 months. Re-treatment was then considered only if there were any signs of membrane activity.

In five eyes, three injections of Avastin led to a complete resolution of leakage on fluorescein angiography and OCT. In one eye, membrane activity persisted despite six injections of the drug. Visual acuity improved in five eyes with a mean improvement of four lines (range: 2-10 lines). It deteriorated only in the eye that did not respond to treatment.

The results of this case series suggest that the intravitreal injection of Avastin may be an effective treatment for peripapillary choroidal membranes.